Many people still believe that if HIV doesn't kill you, then HIV-related complications will. But that is not true. Managing complications from HIV is a far cry from what it was in the past. If you and your doctor are vigilant, staying healthy and living a full life with HIV are very possible.
"In the current era, patients should not feel as though HIV is in any way a death sentence,” says Monica Gandhi, MD, MPH, director of the HIV Consult Service at San Francisco General Hospital.
In fact, many HIV complications can be avoided, says Babafemi O. Taiwo, MBBS, an internist and assistant professor of infectious diseases at Northwestern University’s Feinberg School of Medicine in Chicago. "This is not 1985, when you had to take AZT and you had to live with anemia," he says. "The notion that you have to suffer through an HIV regimen is really archaic. You can find a regimen that best suits your lifestyle with no adverse effects."
The disease still offers its challenges, say these two HIV experts. But HIV medications are much less toxic and easier to tolerate than in the past. Staying healthy with HIV is now within reach if you protect your overall health and work closely with your doctor to avoid complications.
Complications of HIV Infection
If you experience complications, it can be difficult to know whether they are from the drugs or related to having HIV itself. "Some conditions of 'chronic inflammation' are presumably linked to the HIV infection," says Gandhi, who is also associate professor of medicine in the divisions of HIV/AIDS and infectious diseases at the University of California in San Francisco. These include a greater likelihood of:
- Heart disease
- Liver disease
- Kidney disease
- Nerve damage
- Eye disease
The immune system may never fully recover from damage after HIV infection. This becomes more apparent as people with HIV reach their 50s, Taifo says. Problems that often come with aging -- such as bone thinning, frailty, or memory loss -- are showing up earlier in these people than in those who are uninfected.
Still, some of these problems can be slowed down, or even averted, by taking care of your health. "Even if some damage has been done by chronic HIV infection, a lot can be reversed by managing lipids aggressively and by not smoking or by starting exercise," Gandhi says. The same would be true for someone who is not HIV-infected.
Severe weakening of the immune system can also lead to opportunistic infections such as:
- Pneumocystis carinii pneumonia (PCP)
- Candidiasis ( thrush)
- Cytomegalovirus ( CMV)
- Tuberculosis (TB)
- Mycobacterium avium complex
Complications of HIV Medications
Some of the more common HIV medication complications are related to metabolism, the chemical processes needed for life. What form they take depends upon the type and class of medication. They include:
- Body fat abnormalities, such as facial fat loss or extra belly fat
- Insulin resistance, leading to blood sugar problems
- Problems with metabolism of fats (lipids)
- A buildup of lactic acid in the blood
- Bone disease, such as osteoporosis